5 Signs That It’s Time to Upgrade Your Medical Billing Software


5 Signs That It’s Time to Upgrade Your Medical Billing SoftwareThe growing importance of medical billing software can be witnessed at any medical convention. Rather than pharmaceutical companies taking center stage, today’s software companies are in the spotlight.

Healthcare providers are faced with deadlines for simplifying administrative functions, as well as patients and insurance companies who are more than ready for a more efficient filing and billing process.

Can your medical billing software hold its own in today’s world? It may be time for you to upgrade your medical billing software if…

1. You’re Not Absolutely Confident about HIPAA Compliance

The Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996 to streamline transactions in the world of healthcare, protect patient privacy, and establish standards for electronic healthcare records. Under HIPAA, all medical data must meet high standards for both physician and patient privacy, and all healthcare facilities that maintain or transmit healthcare information electronically must comply with HIPAA. Violate HIPAA rules and you can face serious civil and criminal penalties.

Your medical billing software must meet provisions for transaction standards, unique National Provider Identifier requirements, data security, and privacy regulations. Are you confident that your software meets all HIPAA requirements? If not, maybe it’s time to start looking for a better medical billing software solution.

Related: Making the Most of Medical Billing and Coding 

2. Your Software Doesn’t Automatically Update Insurance Eligibility Information

If your medical billing software doesn’t take care of insurance eligibility verification in real time, your practice could be losing tens of thousands of dollars a year. With medical billing software that has real-time insurance eligibility verification, you can find out instantly whether a patient is eligible for insurance payments, saving you countless hours you might have spent on the phone chasing down this information.

When your medical billing software automatically updates insurance eligibility information, you can find out which visits patients will be required to pay for themselves and tell them up front. You’ll also reduce the number of claims that have to be resubmitted, saving significant money and time. Additionally, you can be confident that the co-pays you collect up front are correct so you’ll spend less time chasing co-payments after the patient’s visit is over.

3. Lack of Automation Is Bogging Down Billing Staff

Even in the age of electronic data collection and storage, your practice may be awash in paper, with your staff processing huge amounts of paperwork every day. This is inefficient and raises your office’s overhead. New medical billing software, however, can manage large numbers of claims at once, relieving employees of the tedium of submitting them individually. With a more efficient billing process in place, patients and employees will find the start-to-finish office visit much more efficient.

Related: The 3 Coolest Features of Medical Billing Software 

4. You Want to Be Ready for the Affordable Care Act

Administrative simplification is an important aspect of the Affordable Care Act. Section 1104 of the ACA provides for:

  • Standardization of electronic billing
  • Determination of patient and provider responsibility up front at the point of care
  • Comprehensive billing that minimizes use of paper and cuts down on phone calls verifying eligibility
  • Quicker reimbursement for health services via electronic transactions

Is your practice ready? Your medical billing software can go a long way toward getting your facility ready for full implementation of the ACA.

5. You Want the Flexibility Provided by Mobile Options

Particularly in some healthcare sectors, there are billing documents and approvals that simply cannot wait. Today’s medical billing software providers are starting to incorporate mobile capabilities so that the billing software is available at all times.

If you are a physician who may be asked for approval or other information for billing, yet you are out of the office doing rounds or delivering a baby, mobile capability can dramatically improve your practice’s billing process. New features like electronic signature capability can save you hours of sitting at your desk signing papers, because you can sign using your mobile device wherever you have a secure data connection.

Much is demanded of today’s medical billing software. From HIPAA compliance to getting ready for the Affordable Care Act, your billing software can either help your practice grow while improving efficiency, or bog down your staff with repetitive procedures, driving up overhead costs. There has never been a better time to assess your medical billing software and learn your options if it’s time to upgrade.

To view a list of companies with these services, see our medical billing software resource page.

Photo Credit: Official U.S. Navy Imagery


Business.com Editorial Staff

Business.com Editorial Staff

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One Response to 5 Signs That It’s Time to Upgrade Your Medical Billing Software

  1. JIm Poppell says:

    Dont forget specifically 5010 compliance, ICD10 implementation and free EDI that flags errors before the claim gets to the clearinghouse

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